Tumescent is a treatment administered just prior
to liposuction, during the same surgical session. This method of
liposuction is the oldest version that is still utilized today.

Tumescent involves utilizing the area to be
treated with sterile solution to help plump the fat cells and distinguish the fat
layer from the overlying soft tissue and underlying muscle and organs.
Essentially, tumescent magnifies the fat layer, making it technically easier to
remove. The saline is generally combined with the appropriate balance of lidocaine or some other local anesthetic
for the patient's comfort during and
immediately after liposuction, and epinephrine to constrict blood vessels and
reduce bleeding and bruising.

The Wet
Technique refers to the use of fluid injection prior to liposuction treatment.
The surgeon administers a small amount of fluid, less in volume than the amount
of fat to be removed. (which contains
epinephrine) directly into the tissue. The amount of fluid is
somewhere around six to eight ounces.

This solution contains:

lidocaine -
anesthetize the local area

epinephrine - constrict
the blood vessels to minimize bleeding

saline - helps separate the
tissues during the procedure

This injected fluid helps to loosen the fat cells and reduce bruising. This results in less blood loss
during the procedure and also will reduce the amount of patient discomfort after
surgery.

This technique is done with injecting a solution in which contains lesser amount
of anesthetics (lidocaine and epinephrine). This procedure requires either
IV sedation or general anesthesia.

Basically the
super-wet technique is similar to tumescent liposuction but introduces less
fluid into the area to be treated: Normally a 1:1 proportion of the fluid to
inject to the fat/fluid aspirated. Super Wet Liposuction is a safe method, and
some say safer than tumescent liposuction because of the fact there is a lower
risk of fluid overload.

There
is more blood loss with the super-wet method than with the tumescent technique.
It has been stated that eight percent of the fluid removed through "super wet"
is in fact blood - unlike the tumescent technique where only one percent of the
fluid removed is blood.

The benefits of the Super Wet Technique
is that the surgeon doesn't have to wait for swelling to go down before starting
the liposuction. The procedure takes approximately two hours and the
patient can also opt to have other procedures done at the same time. The
procedure time is much quicker than the tumescent method which could possibly
take up to four or five hours.

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Anesthesia used for Tumescent Liposuction

Tumescent liposuction fluid numbs the entire
surgical area - and the effects of the tumescent fluid permits the patient to
remain comfortable for several hours after the procedure.

Tumescent liposuction can be done under the
following methods of anesthesia:

Tumescent Solution
is composed of Epinephrine, Lidocaine,
and Saline - which is injected into the surgical area where the liposuction is going to
be performed. Tumescent anesthesia with highly diluted lidocaine and
epinephrine has transformed lipoplasty from a highly vascular surgery to a
painless and bloodless procedure.

The area after injection
becomes swollen immediately which comes from the surrounding tissue absorbing
the medication.

How Tumescent Anesthesia
Works:

Saline helps separate
the tissues during the procedure – making the dissection much less traumatic

Epinephrine causes the
tiny blood vessels in the area to constrict, minimizing bleeding and bruising.

Lidocaine numbs the
area to provide pain control.

With tumescent
anesthesia, large volumes of anesthesia are used in much lower
concentrations.

Fluid accumulation (seromas)
- if this complication occurs, the fluid will need to be drained.

COMMON
SIDE EFFECTS FROM TUMESCENT ANESTHESIA OR SOLUTION

Common side effects of tumescent lidocaine that are not
considered signs of toxicity include:

Mild sleepiness
– some patients might experience some sleepiness during and
after tumescent liposuction, even if no sedatives are given.

Nausea and vomiting
– nausea and vomiting associated with tumescent local
anesthesia is not common, but it can occur. Other drugs that are given
during the procedure such as antibiotics, sedatives related to Valium, and
all narcotics can increase nausea and vomiting. Most medications
should be given on a full stomach, to minimize nausea.